Somatosensory Training Versus Exercise Therapy in Awake Bruxism
Somatosensory Training Versus Exercise Therapy in Awake Bruxism: A Randomized Controlled Trial
Aydin Adnan Menderes University
20 participants
Dec 16, 2025
INTERVENTIONAL
Conditions
Summary
Awake bruxism (daytime teeth clenching or jaw tension) is a common condition that can cause jaw pain, facial pain, muscle fatigue, and reduced quality of life. Although current treatments often focus on the jaw muscles and posture, recent research suggests that changes in the brain's sensory processing may also play an important role in bruxism-related pain. This randomized controlled trial aims to compare two physiotherapy-based treatment approaches with a wait-list control group in adults with awake bruxism. Participants will be randomly assigned to one of three groups: (1) somatosensory awareness-based training, (2) jaw and posture exercise therapy, or (3) a wait-list control group. The somatosensory training program focuses on improving body awareness and sensory perception of the face and jaw, while the exercise program includes jaw mobility, postural alignment, and cervical exercises. Both active interventions will be delivered over a 4-week period. Participants will be assessed at baseline, immediately after treatment, and during follow-up to evaluate changes over time. The main outcome of this study is orofacial pain intensity. Secondary outcomes include jaw function, sensory processing, muscle structure, oral parafunctional behaviors, and oral health-related quality of life. The results of this study may help improve physiotherapy-based treatment strategies for people with awake bruxism by addressing both physical and sensory aspects of the condition.
Eligibility
Inclusion Criteria8
- Adults aged 18 to 45 years
- Clinical diagnosis of awake bruxism confirmed using standardized diagnostic criteria (STAB and DC/TMD Axis I)
- Presence of at least one measurable somatosensory alteration confirmed at baseline using digital and clinical assessments
- Self-reported daytime jaw clenching or parafunctional activity
- Baseline orofacial pain intensity of ≥5/10 on a Visual Analog Scale (VAS)
- Chronic pain graded as GCPS Grades I-III according to DC/TMD Axis II (Turkish validated version)
- Willingness to comply with the study protocol and attend scheduled treatment sessions
- Ability to understand the study procedures and provide written informed consent
Exclusion Criteria6
- GCPS Grade IV (high disability level)
- Presence of systemic inflammatory, neurological, or rheumatological disorders
- Diagnosis of severe chronic pain conditions unrelated to bruxism
- Use of occlusal splints or participation in jaw, neck, or facial therapy within the past 3 months
- Psychiatric disorders or cognitive impairment that could interfere with study participation
- Pregnancy, due to potential effects on joint laxity and postural parameters
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Interventions
Participants assigned to this group receive a structured jaw and posture exercise therapy program delivered by a physiotherapist. The intervention consists of supervised face-to-face sessions twice per week over a 4-week period, combined with a home exercise program performed on non-supervised days. The program includes jaw mobility and relaxation exercises, postural correction and stabilization exercises, and cervical region exercises. In addition, manual therapy techniques are applied as clinically indicated, including ischemic trigger point therapy, cervical joint mobilization, and intraoral manual techniques. Each treatment session lasts approximately 40-45 minutes. Adherence to the home exercise program is monitored throughout the intervention period.
Participants in this group receive an individualized somatosensory awareness-based training program designed to target altered sensory perception and body schema related to the face and jaw. The intervention focuses on laterality recognition, body schema representation, and tactile discrimination, including two-point discrimination-based tasks. No conventional exercise therapy or manual therapy techniques are provided in this group. The training is delivered using a flexible, patient-specific approach, supported by structured guidance materials aimed at increasing daily awareness and self-monitoring of somatosensory experiences. Participant adherence and engagement are monitored through regular follow-up and self-report tracking.
Participants allocated to the wait-list control group do not receive any active treatment during the initial study period and continue their usual daily activities. All outcome assessments are conducted at the same time points as the intervention groups. After completion of the assessment phase, participants in this group are offered exercise therapy according to clinical need.
Locations(2)
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NCT07336082